435202571-2-27-2026-26-AS-RMAO-DS2PMY-20260310112708

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202571
Report Date: 02/26/2026
Date Signed: 02/27/2026 08:50:52 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/05/2025 and conducted by Evaluator Chihhsien Chang

COMPLAINT CONTROL NUMBER: 26-AS-20251105160018

FACILITY NAME:	BELLEROSE SENIOR LIVING		FACILITY NUMBER:	435202571
ADMINISTRATOR:	LORI CORRAL		FACILITY TYPE:	740
ADDRESS:	100 BELLEROSE		TELEPHONE:	(888) 324-6520
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95128
CAPACITY:	26	CENSUS: 21	DATE:	02/26/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Lori Corral		TIME COMPLETED:	01:33 PM

ALLEGATION(S):

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Staff did not prevent resident from being sexually assaulted.
Staff left resident in soiled diapers for an extended period of time.
Staff are not meeting resident's hygiene needs.
Staff are not meeting resident's clothing needs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Steve Chang conducted an unannounced investigation visit to deliver the investigation findings and met with Administrator (ADM) Lori Corral.

On 11/05/2025, the Department received a complaint with the above 4 allegations.

On 11/06/2025, the Department conducted an initial investigation visit.

On 01/09/2026, LPA conducted an investigation visit.

LPA interviewed ADM, 4 staff, and 3 residents.

Continue on LIC9099-C. Page 1 of 4.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 4

Control Number 26-AS-20251105160018

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: BELLEROSE SENIOR LIVING	FACILITY NUMBER: 435202571
	VISIT DATE: 02/26/2026

NARRATIVE

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Staff did not prevent resident from being sexually assaulted:

On 01/09/2026, LPA interviewed Administrator (ADM) Lori Corral. ADM stated the resident R1's family member FM1 has not been at the facility for over one year. ADM stated police officers came to the facility to investigate on 11/05/2025 and did not have a police case number. ADM stated APS (Adult Protection Service ) staff came to the facility to investigate on 11/06/2025 and the case was closed.

ADM stated the facility never left any resident in the facility parking. ADM stated R1 was never put in the parking lot alone. ADM stated he/she did not receive any report that R1 was being sexually assaulted.

On 11/06/2025, R1's POA told LPA on the phone that R1 lives at the facility for 8 years and never has any issue with the facility or with any facility staff. R1's POA stated the allegation is not true.

Staff left resident in soiled diapers for an extended period of time:

On 01/09/2026, LPA interviewed ADM. ADM stated each shift caregivers checked/changed residents' diapers at least 2 times within a shift and help resident for toileting. LPA interviewed 3 caregivers who work either at AM shift or PM shift. 3 Out of 3 caregivers stated they check/change residents' diapers at least 2 times and as needed in each shift.

LPA interviewed 3 residents (R1, R2, R3). 2 Out of 3 residents stated the facility staff change their diapers around 3 hours and 1 Out of 3 residents stated the staff change the diaper in a timely manner. 3 Out of 3 residents stated they have no complaint against the facility.

On 11/06/2025, R1's POA told LPA that R1 lives in the facility for over 8 years and never has any issues. R1's POA stated the allegation is not true.

Continue on LIC9099-C. Page 2 of 4.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 26-AS-20251105160018

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: BELLEROSE SENIOR LIVING	FACILITY NUMBER: 435202571
	VISIT DATE: 02/26/2026

NARRATIVE

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Staff are not meeting resident's hygiene need:

On 01/09/2026, LPA interviewed ADM. ADM stated the facility provides haircut and styling service to residents every 6 to 8 weeks. ADM stated the facility staff help residents for teeth brushing at least two times, one in the morning and one before bedtime.

LPA interviewed 2 staff (S1, S2) who work in the AM shift. Both stated they help residents brushing teeth two times in their shift, one after residents wake up, and one after lunch. Both stated around every two months the facility provides hair cut service to residents.

On 01/09/2026, during the interview with R1, LPA observed resident R1's hair was well-groomed and R1's overall appearance looked neat.

On 11/06/2025, R1's POA talked to LPA on the phone and stated the allegation is not true. R1 does not have any issue in the facility.

Staff are not meeting resident's clothing needs:

On 01/09/2026, LPA interviewed ADM. ADM stated residents are changed to pajamas before going to bed and are changed to daily clothes when getting up. ADM stated if residents' clothes do not fit, the facility notifies families to provide new clothes for the residents. ADM stated that the facility did not find R1 has any issue of clothes that do not fit.

LPA interviewed 2 staff (S1, S2). Both stated they did not find R1's clothes do not fit R1.

On 01/09/2026, during the interview with R1, LPA observed R1's clothes were not tied, the clothes were fit for R1.

On 11/06/2025, R1's POA talked to LPA on the phone and stated the allegation is not true. R1 does not have any issue in the facility.
Continue on LIC9099-C. Page 3 of 4.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 26-AS-20251105160018

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: BELLEROSE SENIOR LIVING	FACILITY NUMBER: 435202571
	VISIT DATE: 02/26/2026

NARRATIVE

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Based on the statement made by resident R1's POA on 11/06/2025, all the 4 accusations/allegations are not true, R1 has been living at the facility for 8 years, and has not had any problem with staff or with the facility.

The Department has investigated the above allegations. Based on the investigation, record reviewed, and interviews conducted, the Department found that the above allegations are UNFOUNDED, meaning that the allegation is false, could not have happened and/or is without a reasonable basis.

No citation noted today. Exit interview was conducted with ADM. The report was provided to ADM for signature. A copy of the report was provided to ADM.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 4